Gorman Shelley, Weller Richard B
Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.
Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom.
Front Cardiovasc Med. 2020 Dec 23;7:616527. doi: 10.3389/fcvm.2020.616527. eCollection 2020.
During the COVID-19 (coronavirus disease of 2019) pandemic, researchers have been seeking low-cost and accessible means of providing protection from its harms, particularly for at-risk individuals such as those with cardiovascular disease, diabetes and obesity. One possible way is via safe sun exposure, and/or dietary supplementation with induced beneficial mediators (e.g., vitamin D). In this narrative review, we provide rationale and updated evidence on the potential benefits and harms of sun exposure and ultraviolet (UV) light that may impact COVID-19. We review recent studies that provide new evidence for any benefits (or otherwise) of UV light, sun exposure, and the induced mediators, vitamin D and nitric oxide, and their potential to modulate morbidity and mortality induced by infection with SARS-CoV-2 (severe acute respiratory disease coronavirus-2). We identified substantial interest in this research area, with many commentaries and reviews already published; however, most of these have focused on vitamin D, with less consideration of UV light (or sun exposure) or other mediators such as nitric oxide. Data collected to-date suggest that ambient levels of both UVA and UVB may be beneficial for reducing severity or mortality due to COVID-19, with some inconsistent findings. Currently unresolved are the nature of the associations between blood 25-hydroxyvitamin D and COVID-19 measures, with more prospective data needed that better consider lifestyle factors, such as physical activity and personal sun exposure levels. Another short-coming has been a lack of measurement of sun exposure, and its potential to influence COVID-19 outcomes. We also discuss possible mechanisms by which sun exposure, UV light and induced mediators could affect COVID-19 morbidity and mortality, by focusing on likely effects on viral pathogenesis, immunity and inflammation, and potential cardiometabolic protective mechanisms. Finally, we explore potential issues including the impacts of exposure to high dose UV radiation on COVID-19 and vaccination, and effective and safe doses for vitamin D supplementation.
在2019冠状病毒病（COVID-19）大流行期间，研究人员一直在寻找低成本且易于获得的方法来预防其危害，特别是对于心血管疾病、糖尿病和肥胖症等高危人群。一种可能的方法是通过安全的阳光照射和/或补充具有诱导有益介质（如维生素D）的膳食。在这篇叙述性综述中，我们提供了关于阳光照射和紫外线（UV）可能影响COVID-19的潜在益处和危害的理论依据和最新证据。我们回顾了最近的研究，这些研究为紫外线、阳光照射以及诱导介质维生素D和一氧化氮的任何益处（或其他方面）提供了新证据，以及它们调节由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染引起的发病率和死亡率的潜力。我们发现该研究领域受到了广泛关注，已经发表了许多评论和综述；然而，其中大多数都集中在维生素D上，对紫外线（或阳光照射）或其他介质如一氧化氮的考虑较少。迄今为止收集的数据表明，UVA和UVB的环境水平可能有助于降低COVID-19导致的严重程度或死亡率，但也有一些不一致的发现。目前尚未解决的是血液中25-羟基维生素D与COVID-19相关指标之间关联的性质，需要更多前瞻性数据，更好地考虑生活方式因素，如身体活动和个人阳光照射水平。另一个不足之处是缺乏对阳光照射及其影响COVID-19结果潜力的测量。我们还讨论了阳光照射、紫外线和诱导介质可能影响COVID-19发病率和死亡率的可能机制，重点关注对病毒发病机制、免疫和炎症的可能影响以及潜在的心脏代谢保护机制。最后，我们探讨了潜在问题，包括高剂量紫外线辐射暴露对COVID-19和疫苗接种的影响，以及维生素D补充的有效和安全剂量。
